(This will be lengthy, complicated and most likely a bit incoherent. I've posted it on a few forums, partly to get a range of opinions, but also to basically get it off my chest. To anyone who manages to get through it all and makes sense of it - i'm very grateful for your patience!)

Hi everyone,

Firstly a bit of history. I'm a 24 year old male. My OCD first got really bad back when i was 19, initially revolving around handwashing which was itself linked to germ phobia, emetophobia etc. Over the years i've made improvements in this area (the handwashing takes about 5-10 minutes rather than 2 hours now!), but there's still work to be done.

The second main element of my OCD developed about 18 months after that. Commonly known as P-OCD online, it was based around terrifying and very real-seeming intrusive thoughts that i might be a paedophile. At first this brought me to the point of contemplating suicide, but after opening up to my then-psychologist about it, i started to gradually get the thoughts into perspective. It still flares up from time to time but i feel much more in control of it.

I had taken the beta-blocker propanolol for a brief period back in 2008, but before this year, i'd never really used medication due to my overblown fears of the potential side effects. Three months ago i started taking the tricyclic anti-depressant clomipramine. Due to the concern over side effects as well as my IBS, the doctor recommended that i increase the dosage very gradually - i'm only now up to 60mg per night. I'd perhaps felt a slight improvement in my mood and slight easing of general anxiety, but developemnts from the past few weeks have left me unsure of whether to keep increasing the dosage.

Except for a brief period in my early teens, i've been fairly comfortable with my sexuality - to use totally unscientific figures, about 80% heterosexual and 20% homosexual, basically 'a bit bi'. I'm capable of a homosexual response, but my gut preference has definitely been for girls/women, especially in any romatic/relationship sense.

Over the last few weeks, though, as the clomipramine's started to kick in a bit more, there seems to have been a weird shift in my sexual responses. Basically, my heterosexual response seems to have decreased significantly and my homosexual response seems to have increased somewhat. I'm still capable of a heterosexual response, but it definitely seems to have been reduced. As should be clear, i'm not homophobic (at least not in terms of anyone else's sexuality), but it's REALLY unsettled me for some reason. The thought patterns emerging from the whole thing do seem very OCD - it's making me miserable, i'm terrified that i'll end up incapable of a heterosexual response and my brain keeps testing me/bombarding me with open-ended questions which leave me feeling very confused and alone. Unlike the P-OCD, my core dislike for what the thoughts are suggesting isn't moral - it simply doesn't feel right for me. The idea of actually being gay rather than slightly bi doesn't seem at all liberating to me - it's just depressing me.

At least in part due to severe social anxiety, i've never been in a sexual relationship or had a girlfriend. I've also been VERY isolated from my peer group in recent years.

Another factor which might have been instrumental in recent weeks relates to a computer CBT course i've been taking. It's proved quite useful and given me a few ideas for controlling general anxiety and depression, as well as getting me out of the house a bit more. The confusion starts when i mention the attractive 20 year old girl who has been assigned to help me with the therapy - i developed a bit of a thing for her pretty much from the beginning, although i've found it surprisingly easy to talk to her given my usual awkwardness around the oppostie sex. I haven't taken the 'crush' too seriously - it's probably got more to do with the fact i've barely encountered any girls of my own age over the past four years. On the other hand, it did get me thinking in more general terms about how i'd eventually like to end up in a relationship once i'd gotten my problems and anxieties under control. I also realised, to my confusion, that my attraction to the girl seemed to be purely on a romantic level - for some reason i found it very hard to think of her in a sexual way. At first i assumed this was to do with anxieties, but then i started to wonder whether my heterosexual instincts were really becoming diminished. I then asked myself "could anyone but me manage to develop a crush on a girl and then convince themselves that they were turning gay all within the same week?" This helped to ease my concerns for a few days, but they now seem to be taking over again and i feel really helpless. Which brings me to typing this message.

The question "is the clomipramine turning me gay?" sounds pretty ridiculous i'll admit, but to frame it another way, could the clomipramine be doing something strange on a hormonal level which might present as a shift in sexual tendencies? On the other hand, working with the idea that this IS H-OCD, might the clomipramine be actively causing the new intrusive thoughts/making them worse and should i think seriously about whether continuing with this medication is going to help or hinder me? Or perhaps might the whole thing be related to anxieties surrounding my attraction to the CBT girl?

I realise that this is a bit of a mess, but the situation is really getting me down, so i'd be very grateful for any advice.

Thanks for reading.